Document 6538800

INITIALLIST OF MANAGERSOR MANAGINGMEMBERSAND REGISTERED
AGENTAND
STATEBUSINESSLICENSEAPPLICATIONOF:
FILE
NUI\{BER
SAMPLE FILING FOR LLC
N A MEO F L I M I T E D - L I A B I L I T
CYOM PANY
pERroD
FoRrHEFTLTNG
412025
41202:6
oF
ro
**YOU MAY FILE THIS FORM
ONLINE AT www.nvsos.gov**
FORM
SAMPLE
DONOTFILE
The entity'sduly appointedregisteredagent in the Stateof Nevadauponwhom processcan be servedis:
CHQ Incorporated
2235 E. FlamingoRd, Ste 201 G
Las Vegas,Nevada89119
gOV
A F O RMT O C H A N G ER E G IST ERED
AGENTINF ORM AT ION
IS F OU N DA T: w vvw .nV S OS
lf you are claimingan exemptionto the StateBusinessLicense,check the box
under#1, andenterthe proper"code" under#2.
Completeone (or more as required) namefieldsunder #3.
Checkeither a "Manager"or "Member" box under #4.
Signthe form at #5. Do not sign anywhereelse.
f ilino
l N l T l A LL I S TF I L I NGF EE:$ 1 2 5 .0 0
clrpllt
L AT EPENAL T Y:$ 75.00
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onlyif applicable
Ll
Pursuant
to NRS,thisentityis exemptfromthebusiness
licensefee.
LJ
Mont[f,nCF?r yourStateBusiness
Licenseexpires:
i
G' V
Exemptioncode:
)Or
z't
@v
(DOCUMENTWILL BE REJECTEDIF TITLE NOT INDICATED)
NA ME
n
ADDRE S S
rvrnruncEn
!
C ITY
P. O. Box 70477
MANAGING
MEMBER
S TA TE ZIP COD E
NV
Las Veqas
89170
(DOCUMENT
WILL BE REJECTEDIF TITLENOTINDICATED)
N A ME
II
A DDRE S S
MANAGER
I
CITY
P. O. Bax 70477
I MANAGINGMEMBER
STATE
ZIP CODE
NV- :,
Las Vegas
N A ME
tgtZ O
(D OC U ME N T
WILL B E R E JE C TE DIF TITLEN OT IN D IC A TE D )
n
A DDRE S S
r'rnNncen
!
CITY
P. O. Box 70477
MANAGTNG
MEMBER
STATE
NV
Las Vepas
N A ME
ZIP CODE
89.t70
(D OC U ME N T
WILL B E R E JE C TE DIF TITLEN OT IN D IC A TE D )
n
A DDRE S S
,P.
Section7(2) ExemptionCodes
001- Governmental
Entity
Entity
002- 501(c)Nonprofit
Business
003- Home-based
005- MotionPicture
Company
O. Box 70477
rrrrnr.rncen
C ITY
!
MEMBER
MANAGTNG
STATE
Las Vesas
NV
ZIP CODE
89170
I'declare,tothe bestof my knowledge under penalty of perjury, thatthe above mentioned entity has complied with the provisions of sections 6 to 18 of AB 146 of
the 2009 session of the Nevada Legislatureand acknowledgethat pursuant to NRS 239.330,it is a category C felony to knowingly offer any false or forged
instrument for filing in the Office of the Secretarybf State.
xov
Signatureof Manageror ManagingMember
Date
NevadaSecretaryof State InitialList ManorMem
Revised:8-28-09